Saturday, August 2, 2014

As reported earlier this week*, a retired professor and a PhD graduate student from the
University of Toronto Mississauga claim that they have disproved the theory
that Lyme disease causes Alzheimer's disease. But, exactly how did they disprove a link? Did they test a large number
of Alzheimer's patients for Borrelia
burgdorferi antibodies using several assays? No. Did they employ an expert pathologist - one highly-skilled
and experienced in the tedious process of identifying Borrelia spirochetes - to
perform extensive autopsies on a large number of deceased Alzheimer's
patients? Negative. Did they track a
large number of Lyme disease patients for decades to see whether any of them
developed symptoms of Alzheimer's disease?
Nope.

The researchers say they used "statistical
analysis" to disprove an Alzheimer's-Lyme link. By noting where the reported cases of Lyme
disease occur vs. where people with Alzheimer's disease are found, they say
they’ve ruled out the possibility that Lyme disease may cause Alzheimer’s
disease.

Well, their theory may have actually held weight except in
the case of controversial Lyme disease, where, sadly, it’s not so simple. The researchers
seem to have made several assumptions without an investigation of the caveats and actual facts. These facts may blow their “There is no
Lyme-Alzheimer link” conclusion right out of the water.

At GALDA, we thought of four important reasons that an
Alzheimer’s-Lyme disease link cannot be ruled out using geographical disease statistics. Maybe you can think of more.

1. Reporting practices are not the same. The authors of the paper apparently didn't
actually check, but used the assumption that all states/regions use the same Lyme
disease reporting practices. They don’t,
and they haven’t for decades. There are potentially thousands of Lyme disease cases that are never reported in states outside the
northeastern USA simply because those states use completely different reporting
practices. There is no way to compare Lyme disease statistics when rashes alone
are reported as cases in the northeastern USA and rashes alone are not reported
as cases elsewhere. (Note: It’s
estimated that cases involving rashes alone without evidence of tick bite or
positive test results make up 70% of cases reported in so-called “Lyme endemic states". Thousands and thousands of cases of rashes following
tick bites (many even with serological evidence suggestive of LD) go unreported in so-called “nonendemic areas" because rashes alone
do not qualify to be reported as cases in these regions.)

2. Federal funding to
track Lyme disease is awarded in a biased way. Adding
to reporting practice problems, most state health departments have not been
provided federal funding to actually track Lyme disease cases, a very
expensive, labor-intensive task. The
states awarded funding to track the disease become the states where reported Lyme
disease incidence rates are high. (Duh!) How
many actual cases would all states show if they were also awarded federal
funding and were allowed to use the exact same criteria to report a
case? Statistics cannot be compared when only a few states have money to actively track Lyme disease.

3. North American Lyme
tests are not designed to detect infection caused by various Lyme bacterial
species. Lyme disease statistics may not
reflect the hundreds to hundreds of thousands of patients who are infected with
other Lyme disease bacterial species each year. There is so much that is unknown, but with more and more newly-identified strains of
Lyme bacteria being discovered in various tick species, animals and symptomatic
humans in America and around the world, the probability that there are a vast
number of undetected Lyme Borreliosis cases caused by bacterial species other
than Borrelia burgdorferi sensu stricto
is great. While European Lyme tests
include three species of Lyme Borrelia to increase their reliability, clinical Lyme disease tests currently
used in North America are only geared to detect a single strain of one
species of Borrelia burgdorferi (Bb). This is preposterous. In
the southeastern USA alone, there are at least six species of Lyme bacteria documented (and potentially hundreds to
thousands of strains of each species) but U.S. clinical tests only look for one. Thus, there’s no telling how many suffering people in North
America may actually be infected with some form of Lyme Borreliosis. Using better tests designed to detect more Borrelia strains, we may discover that Lyme disease is actually extremely prevalent in regions where it is now currently considered “rare.” Here again, trying to geographically compare Alzheimer's disease and Lyme Borreliosis case numbers is impossible.

4. Unproven myths greatly affect statistics. Myths
and misconceptions such as, Lyme disease doesn't occur in this region, prevent cases from being recognized, diagnosed, treated and reported by medical providers. As an example, the State of Georgia provided
funding for free Lyme testing in 1989 and actually encouraged physicians to
look for the disease. Subsequently,
Georgia reported 715 Lyme disease cases to the CDC that year, the fourth
highest state in the nation. But, with
no money to track future cases and a new widespread but unproven myth circulating that
erythema migrans (EM) rash and Lyme disease symptoms in tick bite patients in the
southern USA "is not Lyme disease,” but is caused instead by some “unknown" entity, Georgia case numbers plummeted.

( As officials began to actively discourage medical providers from looking for Lyme disease in the South, most southern states thereafter did not use the national reporting
case definition - despite published evidence showing Missouri lone star tick bite
EM patients tested positive for Lyme disease by the CDC and Borrelia
spirochetes were silver-stained and documented under the microscope in some of
these cases.)

Though for decades,
thousands of southern tick bite patients have developed a rash, Lyme symptoms
and tested positive for Lyme disease, myths - including the circular reasoning,
We don’t have Lyme disease here so we can’t have Lyme disease here, and, Positive
test results outside “endemic areas” are only false positives - continue to prevent the diagnosis and treatment of suffering patients. Misconceptions such as these greatly
contribute to the under-reporting of Lyme disease in entire regions.

In conclusion, a statistical analysis of reported case
numbers may be a good method of extracting and comparing important data in many instances,
but in the world of Lyme disease, it’s nearly pointless. Clearly, the researchers thought they might
produce valid evidence. Unfortunately, they didn't investigate thoroughly enough. Considering the many problems, an accurate geographical comparison
of Lyme disease statistics with other diseases, including Alzheimer's, cannot possibly be made at this time.

Thursday, July 24, 2014

At GALDA, we don't like to bash medical providers but there is so much potentially harmful,
misleading information in the article, Monitor
Board of Contributors: Know your biting bugs (and how to protect from them)! published online this week by the Concord Monitor, we feel compelled to warn the public.
It's quite troubling that the article, full of inaccuracies, was written by a pediatrician and president
of Concord Pediatrics.

In the piece, Dr. Patricia Edwards advises readers not to
worry about wood ticks or dog ticks claiming these are "only
annoying." It's hard to imagine that this physician has never heard of the potentially fatal Spotted
Fever Rickettsiosis and the other serious diseases spread by different tick species (including the "dog ticks" she mentions). Isn't she aware that tick-borne
disease science is constantly evolving and that an alarming number of pathogens
have been discovered in ticks in recent decades? In fact, even Borrelia
burgdorferi (Bb) - the organism that causes Lyme disease – has been
documented in other tick species including dog ticks and lone star ticks. Research
shows that the transmission of Lyme disease appears to depend upon the
host, meaning we cannot rule out transmission to humans by other tick species. People should never be advised to be dismissive about a
tick bite due to the type of tick removed.

Next, Dr. Edwards should know, Ixodes
scapularis ("deer ticks") do not get big enough to see
"within hours." Typically, engorgement happens rather gradually as they feed over several days.

-courtesy Bugguide.net

The doctor also writes that a tick must be attached for at
least 36 hours to transmit Lyme disease (LD). Though this is often touted by many, it's not necessarily true, as demonstrated in studies published long ago. Some studies suggested that ticks may sometimes transmit LD in less than 12 hours. In addition, some tick-borne diseases, such as Rocky Mountain Spotted Fever (RMSF), are known to be transmitted in only a few hours. RMSF and other tick-borne infections may prove
quickly fatal.

Readers must be advised
to seek immediate medical attention should symptoms develop following any tick
bite, no matter how long the tick may have been attached. Medical providers must remember these other diseases may be transmitted more quickly and by various species of ticks. Early diagnosis and treatment can mean the difference between life and death.

Ticks may have infectious
secretions that shouldn't be touched with bare hands. In fact, Borrelia burgdorferi has been documented
in tick saliva and, more recently, in tick excrement. See article linked here:

Dr. Edwards mentioned prophylactic treatment after a tick
bite, but be careful. A one or two dose Doxycycline regimen is often recommended by the IDSA as a "prophylactic
treatment" to prevent Lyme disease, however,this treatment has not been
proven to be effective and is highly controversial. Thismay prevent a rash from forming, but may not stop
the actual infection. Plus, a recent CDC study
proved that trying to prevent Lyme disease by taking 1-2 Doxycycline doses is a really bad idea. Here's the link:

(As an aside, another serious concern about the 1-2 dose Doxycycline regimen is that taking too little of an
antibiotic during the early stages of infection may stop antibodies from
forming against the Lyme bacteria, thereby causing a person to test negative by
antibody test, even if they are still infected. This may create a diagnostic nightmare! This phenomenon
has been documented in early syphilis as well as in early Borreliosis
cases.)

Finally, Dr. Edwards writes that "prolonged treatment
with antibiotics is not indicated and can often be dangerous.” She fails to mention that one clinical trial clearly showed patients improved when they were treated with longer courses of antibiotics. She doesn't share that there is no study that has ever proved that a few weeks of antibiotics cures Lyme disease. She doesn't note that many infectious diseases (including Tuberculosis and Lyme's
spirochetal cousin Syphilis) often require longer courses of antibiotic treatment nor that acne patients are treated with Doxycycline for months to years, with few problems.

The article doesn't compare the true risks: the danger of longer antibiotic therapy vs. the danger of allowing
a serious infectious disease to destroy a human body, a human life. Dr. Edwards fails to disclose that scientists and medical providers are at odds about the treatment of Lyme disease and that thousands of Lyme patients (and their physicians) report that they have greatly improved with much longer courses of antibiotics instead of the short courses currently recommended by the IDSA. (The three "longer treatment" clinical trials, by the way, did not examine treatment that lasted very long. Some patients report it takes many months to even years before they really get better. New clinical trials need to examine more lengthy treatment in Lyme disease, especially since it's accepted that other diseases may require such treatment.)

Again, the science is emerging. Treatment is a very controversial subject. This, at least, should have been highlighted by the writer.

*****

In the past several decades, many new pathogens have been identified in ticks, animals and humans. Scientifically and medically as a whole, we probably don't know half of what we need to know about ticks and the organisms they carry. But, even though tick-borne disease science is evolving, medical providers must diligently keep up with all of the latest information. Authoritative doctors risk harming their patients and the public if they are so grossly misinformed.

GALDA implores medical professionals: Because so many people are exposed to tick bites regularly and we're learning these arachnids can carry some really nasty bugs, we urge you to educate yourself on an ongoing basis about ticks and the diseases they carry. It's important to read all of the science, not just that cherry-picked by IDSA and CDC. (It's surprising to see the amount of contradicting published literature available that is routinely ignored.) Don't just visit your old "standby" websites, but sites like the International Lyme and Associated Diseases Society, as well (www.ILADS.org). And investigate for yourself, here's a link to several great Lyme disease medical literature bibliographies to help you get started.

But please, for the sake of your patients, learn all that you can. Your patients need and deserve a super-educated YOU.

*****

Proper tick removal: DO
NOT TOUCH TICKS WITH BARE FINGERS. And,
try not to leave the head in. Both
before and after their use, sterilize fine-nosed tweezers to remove an attached
tick. Grasp the tick with the tweezers as close to the skin as possible. Then, pull straight out. Avoid touching the tick’s body, especially avoid crushing it during removal. Never
twist, turn, burn or apply substances to the tick - these things may cause the
tick to regurgitate its stomach contents (Lyme bacteria, etc.) into your skin. Watch for any signs and symptoms following any tick bite and seek immediate medical care should symptoms develop.

Wednesday, July 9, 2014

What's in your wallet?

It's a catchy line from Capital One's popular advertising campaign. But, instead of inquiring about his wallet, you may seriously want to ask your doctor,

"What's in your laboratory's

Lyme disease test kit?"

- NIH

Recent news articles have described the C6 ELISA as a preferable Lyme disease test. It's still recommended by some at the IDSA as a possible one-step test to detect Lyme disease in humans. It's suggested by others as a "sensitive" screening tool, to be ordered prior to a western blot. In addition, a C6 SNAP test is used by many veterinarians to test dogs and other animals for Lyme Borreliosis. But, is the C6 actually reliable?

After reviewing the published literature, GALDA gives the C6 a big...

Why? Just keep reading...

In 2011, the National Institutes of Health's Dr. Peter Burbelo and his colleagues wrote:

Recently, the C6 SNAP test has been used for the serological diagnosis of equine Lyme disease. Unfortunately, Chang and colleagues found that the C6 SNAP test detected only 63% of known, experimentally B. burgdorferi-infected horses, suggesting that this test is suboptimal for the diagnosis of equine infection. In light of the poor sensitivity of the currently available C6 SNAP test, a better understanding of humoral responses in B. burgdorferi-infected horses is needed.(1)

Another study revealing the insensitivity of the C6 was published in 2012. Lyme-infected monkeys with confirmed evidence of persistent infection were tested over time using the C6 ELISA. The test missed the disease in 50% of the animals. (2)

Worse still, this is nothing new. Dr. Ed Masters explored using the C6 ELISA years ago to test his human Missouri Lyme disease patients. The C6 only detected 7/91 cases, with an additional 6 that were "probable positives."

- Positive cases of Lyme disease detected in dogs using the SNAP C6 ELISA are reported on the IDEXX "Dogs and Ticks.com" website. There are some cases but not a huge percentage reported from the southern USA.

- Chang's work showed that the C6 missed 37% of the horses infected, Embers' work showed the C6 missed 50% of monkeys with persistent infection. And this was in trying to detect one Lyme bacterial species, Borrelia burgdorferi sensu stricto (Bbss). But the C6 is still used quite often in vets' offices to test dogs.

- In the southern USA, there are several other Lyme Borrelia species and strains, not only Bbss, and these may express different determinants that the C6 ELISA doesn't pick up (as suggested by Masters' research). Some of the other Lyme Borrelia species found here, including Borrelia bissettii, Borrelia andersonii and Borrelia americana, have been identified in symptomatic patients in recent years.

- The C6 only detected 7 out of 91 (8%) Missouri Lyme disease cases - cases most likely vectored by the lone star tick since "deer ticks" were said to be rare to nonexistent in Missouri at that time. As Dr. Ed Masters noted in another paper, the whole cell sonicated ELISA detected the greatest number of Lyme cases among his patients, though it was still far from foolproof.

What does it all mean?

So, do the reported cases on the DogsandTicks.com map only represent about 8% of the southern dogs actually infected with various forms of Lyme Borreliosis? How many dogs in the southern USA - where the aggressive lone star tick is so prevalent - are truly infected with some undetected strain(s) of Lyme Borrelia?

Most importantly, what about people infected with other Lyme Borrelia species and strains that the C6 and other Lyme disease tests are not designed to detect?

Buyer beware: there is still no test that can rule out Lyme disease. While the test might be useful sometimes, negative results obtained by using the C6 ELISA cannot be trusted. This may be particularly true in areas where the lone star tick is prevalent and/or so many other species and strains of Lyme Borrelia are known to exist.

So, really...ask your doctors...What's in your laboratory's Lyme disease test kit? Is it a C6 ELISA, a FLA-based ELISA, a whole cell sonicated ELISA? Do you know what studies show about the sensitivity of each one? And what do they show about the reliability of western blots and PCR used in testing for Lyme disease? Because, all of this should matter to doctors who truly care about their patients, especially when so many people may be suffering from an undiagnosed, treatable bacterial infection.

Friday, May 2, 2014

Georgia Lyme Disease Association

(GALDA) Launches New 2014

Metro Atlanta Billboard Campaign.

Geographically, it's the largest Lyme Disease Prevention Billboard Campaign in the world, reaching millions of people.

May 2, 2014,

Atlanta's metropolitan area is the ninth largest in the country, boasting a
population of 5,457,831. GALDA's 2013 metro Atlanta billboard campaign was so
successful, we thought we'd do it again, thanks to our partners at CBS Outdoor
who truly care about the health of Georgia citizens.

Here's a shot of just one of several Georgia Lyme Disease Association billboards and digital posters that will run from April 28 - June 1 in various locations in and around metro Atlanta. During Lyme and Tick-Borne Disease Awareness Month, we hope to raise awareness about tick-borne diseases across the southeastern USA.

GALDA's ads will
also appear all month on the CBS Outdoor Rail Network - the in-car televisions
of the Metro Atlanta Rapid Transit Authority (MARTA) which have the ability to
reach a captive audience of 5.8 million riders every month!

Here's a short version of GALDA's new ad that MARTA riders will see:

At GALDA and CBS
Outdoor, we mean business when we say that we want
all citizens to learn to protect themselves from ticks and the diseases
they can carry. Let us know how many of our ads around metro Atlanta you spot
this month, Georgia!

*******

Our
sincere gratitude goes to CBS Outdoor for partnering with GALDA again this year
to promote awareness about tick-borne diseases and their prevention. Special
thanks to our clever, hard-working account representative Richard Wallace and to
the CBS Outdoor Creative Team headed up by Southeast Hub Creative Director Eddy
Herty. Mwah!

Thursday, May 1, 2014

Again at the request of Georgia Lyme Disease Association

May 1, 2014copyright Georgia Lyme Disease AssociationFor the fifth consecutive
year at Georgia Lyme Disease Association’s request, our Georgia governor has
issued a statewide proclamation deeming May, Lyme and Tick-Borne Disease
Awareness Month. People living in the
southeastern United States encounter ticks so frequently, GALDA again thanks
Governor Nathan Deal for his concern about protecting the health of our
citizens through the promotion of educational and preventative measures.

Working with GALDA, Georgia
was the first state in the southeastern USA to issue a statewide awareness
proclamation in 2010. GALDA board
members have since consulted with patient advocacy organizations in surrounding
states, and other states have now issued Lyme Disease Awareness Month proclamations
including Alabama (2013 and 2014), and new for 2014, Kentucky, Tennessee, North
Carolina and Florida. We’re encouraged to
see states taking such a proactive stance to try to prevent tick-borne
illnesses in our citizens.

Georgia Governor Nathan Deal
and Georgia Lyme Disease Association urge citizens to become educated about
ticks, the diseases they may carry, and ways to prevent tick bites. We encourage people to learn how to remove a
tick properly, since improper removal and/or touching a tick with bare fingers
may actually result in disease transmission in some cases. The public should become familiar with the signs
and symptoms of tick-borne illnesses and seek immediate medical help should symptoms
develop.

Ticks in the southeastern USA
may transmit one or more of several pathogens including:

Lyme disease-causing bacteria - Borrelia burgdorferi sensu stricto, possibly Borrelia andersonii, Borrelia americana and Borrelia bissettii as newer research suggests. Other Lyme Borrelia species may also produce disease in humans, more studies
are needed. At least six different Lyme Borrelia
species have been identified in the southeastern USA, more than in any
other region of the country. Current Lyme
disease testing criteria are only geared to detect a single strain of one Lyme Borrelia species, so many cases may be missed by available tests. Of Note: Restrictive southern reporting
practices (quite different than those used to report cases in the Northeastern
USA) have prevented the reporting of thousands of southern Lyme disease cases
for decades, making it appear as if Lyme disease is not a problem in this
region. Thousands of patients and many
doctors can attest that Lyme disease is a significant problem in our area.

Relapsing Fever Borrelia
– Borrelia turicatae. In addition, the newly-identified relapsing
fever organism Borrelia miyamotoi has
been documented in wild turkeys from Tennessee.
Human studies in the SE USA are needed.
No commercial test is available
yet for B. miyamotoi.

Babesia microti, Babesia duncani, and other Babesia species – cause of Babesiosis. Babesia microti is the only one most doctors in the South will test for, however, research suggests other Babesia species- which may require additional testing to detect - are present.

Ehrlichia – including Ehrlichia chafeensis, Ehrlicha ewingii –
cause of Ehrlichiosis. May produce very serious, acute symptoms and even lead to death in just a short period of time. If suspected, many doctors will just go ahead and prescribe doxycyline because taking a "wait and see" approach can be so dangerous.

Coxiella burnettii – causes
Q-Fever. Cases have been reported in
Georgia and Tennessee, though tick bites are not believed to be the major
source for most cases of this disease.

Bartonella – causes Bartonellosis;
Bartonella henselae is most commonly
known though there are many species. May
be transmitted by other vectors, but in recent years, ticks have also been
implicated. Other Bartonella species have also been found infecting humans. See Dr. Ed Breitschwerdt’s work at North
Carolina State University College of Veterinary Medicine.

Rickettsia – causes what
is now termed, Spotted Fever Rickettsiosis, previously called, Rocky Mountain
Spotted Fever before other Rickettsia species
were known to infect humans. Rickettsia
rickettsii (causes Rocky Mountain Spotted Fever -RMSF); Rickettsia parkeri and Rickettsia
amblyommii may also infect humans and be cross-reactive in testing, causing
a positive RMSF test.

Francisella tularensis – causes Tularemia, generally rare. May be contracted through other vectors and means.

Tick-borne Viruses?
New Heartland Virus and Phlebovirus have been identified in lone star
ticks from other regions in recently.
Lone star ticks, Amblyomma
americanum, are the tick species most commonly found biting humans in the
southeastern USA as well as in many other states, including Virginia. More studies need to be performed in this
region to determine the prevalence of these and other tick-borne
disease-causing organisms in humans.

Tick Paralysis: Not a
disease, but a very serious condition or affliction.

Friday, April 4, 2014

When Dr.
Thomas McPherson Brown appeared on a television interview with Joan Lunden in
1988, she said that his antibiotic arthritis treatment protocol was “turning the medical
world upside down.” Quietly, he replied,
“I’m trying to turn it right side up.”

Dr. Brown
was working at the Rockefeller Institute just before World War II when he
discovered something interesting in the joint fluid of an arthritic patient – an
”L-form” bacteria-like agent. (It was
later identified as a cell-wall-deficient organism now known as, mycoplasma.) Thus, Dr.
Brown wondered whether an infection might be causing the woman’s arthritis. He began treating her and other arthritis
patients with low-level doses of the antibiotic tetracycline, later turning to doxycycline
and minocycline instead. Remarkably, he reported that while the
antibiotic therapy wasn’t a cure, it was an effective treatment for about 90%
of the patients he treated, as long as they "stuck with it." Other medical providers who tried Brown's protocol with their arthritic patients reported similar results.

As head of the arthritis research program at the Veteran’s Administration, medical consultant to the White House and Dean of Medicine at George Washington
University Medical School, Dr. Brown was well-respected. In fact, because his treatment helped so many, he became so popular among patients that they formed a vocal advocacy group of over 10,000 people. They were known as "Doctor Brown's Army." Still (or maybe because of this), he
and his antibiotic therapy were sharply criticized by many in the medical community. Finally, following his death, the results of a
National Institutes of Health clinical trial supported Brown’s claims - his treatment
protocol was indeed effective. Over half
the patients enrolled in the NIH “Minocycline in Rheumatoid Arthritis” (MIRA) study
had improvement in joint pain and swelling. An even greater number showed objective improvement
in their blood test results.

There have now been more than seven major studies published about Brown's antibiotic arthritis therapy. Described in the book The Road Back: Rheumatoid Arthritis, Its Cause and Its Treatment,Dr. Brown’s protocol has benefited thousands of suffering people worldwide. It
continues to be used successfully today (often with rave reviews) and not only by arthritis patients, but by people with other inflammatory connective tissue diseases such as lupus, fibromyalgia and scleroderma, as well.

GALDA Note: Since Lyme disease can lead to arthritis, many won’t be surprised to learn that Lyme Borreliosis patients can often be found visiting RoadBack’s online forums and chat rooms. For more information about Lyme disease, visit
Georgia Lyme Disease Association www.GeorgiaLymeDisease.org or visit us on Facebook.